Sergio Ruben Medrano, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101126 Issued in FL

Practice address

11865 SW 26TH St # a
Miami, FL 33175-2400

Phone

(305) 500-2009

Fax

(305) 500-2145

NPI assigned

Oct 5, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1154519932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CORPORATE CENTER DR",
            "address_2": "SUITE 600",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331261200",
            "telephone_number": "305-500-2009",
            "fax_number": "305-500-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11865 SW 26TH ST # A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331752400",
            "telephone_number": "305-500-2009",
            "fax_number": "305-500-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "SERGIO",
        "middle_name": "RUBEN",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivan Maximialliano Medrano Jr., FNP-BC
• Jose Medrano
• Katherine Marie Medrano, MD
• Luz Isel Medrano, ARNP
• Melanie Victoria Medrano, LMHC
• Medrite Medical Care PC
• Medrite Primary LLC
• Medscape Home Health Care Inc.
• Medscripts Coral Way Dispensary
• Medsearch, Inc.

• Physician Assistant in Miami, FL
• Providers in Miami, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.